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Six Key Elements to Successful Decision-making

By Herve Byron, M.D., New York City

Those of you completing a residency or fellowship program soon will have to make important decisions that will affect your
personal life and medical career. If you make these decisions in a well-designed and logical manner, the challenges you face as you enter the real world of practicing ophthalmology will be less stressful.
Easier said than done, you might say. I agree. I taught a course called Future Focus for many years. In speaking with attendees I sometimes asked what aspects of the course they found valuable. I soon realized that they consistently mentioned the same six concepts. When all six of these concepts factored into their decision-making process, they felt in control and more satisfied with the outcome.
Armed with this information, I developed the following formula: (V + P + F – D) + (F + B) = Control.
I won’t keep you in suspense any longer. Here are the six components of successful decision-making.

Values
The V in my equation stands for personal and professional values, which you must determine for yourself. Your professional values may drive you toward academic achievements, research, teaching or clinical practice. Your personal values may lead you toward supporting civic organizations or charitable causes, or be-coming a great role model and a nurturing parent.

(V + P + F – D) + (F + B) = Control

Prevention
The P is for prevention, which implies that you must do proper due diligence before arriving at any important decision. Weigh-ing the pros and cons carefully beforehand can help prevent disaster.
For example, if you want to practice in a particular location, find out if there’s a need for an ophthalmology practice in that area. Large metropolitan areas may be overcrowded with ophthalmologists, creating a highly competitive environment, while some rural areas may be underserved, giving a new practice an opportunity to thrive. You’ll also want to consider the culture and demographics in a certain area to determine whether or not you’ll be comfortable there and if your type of practice would offer the services that a particular population needs.
Sometimes due diligence in-volves hiring an experienced professional — an attorney, an accountant or a practice manager — who will prevent you from making impulsive or dangerous decisions.

Feelings
The F represents feelings. In other words, trust your gut instincts. Often, your intuition is a more reliable barometer than your brain, which works logically and without passion. As your life be-comes more complicated and you’re faced with increasingly important de-cisions, listening to that inner voice will become more vital to your success.

(Denial)
The negative factor in the equation, the D, stands for denial — a subconscious technique that many physicians use to remain comfortable in the face of unpleasant and threatening circumstances. Unless you’re aware that you’re in this counterproductive frame of mind, your decision-making ability will be impaired. Denial may seem effective for relieving the anxiety and discomfort that comes from unpleasant stressors, but it is a negative when you need to make important decisions.

Family
The F represents family. Your career will thrive if family dynamics are positive and supportive of your career. Deciding where to locate your practice is an example. It’s important to discuss where you’d like to practice and why, the type of practice in which you’d like to work and how that might affect your family. Find out what cultural activities the area offers, the quality of education for your children and the availability of reasonably priced housing near extended family members.
A wise professor once told me the three most stressful experiences facing anyone are death, divorce and moving. Death is unavoidable. Divorce, although not inevitable, is becoming more common, especially among phy-sicians. Moving, on the other hand, definitely is preventable. The professor went on to advise me to buy a large enough first home so I wouldn’t have to move for many years. I wholeheartedly second his advice. If your family is supportive, you’ll know you’re making the right decisions. You’ll be able to concentrate on important professional activities rather than on avoidable personal problems.

Balance
The B stands for balance. Make family time an integral part of your daily, weekly and monthly schedules. Physicians often say they’re too busy with their practice to spend quality time with family. But this is a poor excuse and a distorted view of their roles within their families.
The basis for your support system is your relationship with your spouse and children, especially when facing problems at the office. When you ignore your family, fatigue, frustration and, ultimately, depression are more likely to occur.

Take Control
Remember these six components of successful decision-
making whenever you’re faced with making an important decision. You’ll feel more in control of your personal life and medical career. I cannot overemphasize the importance of this feeling of control, which lessens stress, helps overcome the rough times which inevitably and unexpectedly occur in everyone’s life, and guides you toward a fulfilling career.